Treatment of acute lymphoblastic leukemia in a second remission.

  • Bern M
  • Cloud L
  • Corkery J
 et al. 
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Abstract

To determine the effectiveness of nonoperative and operative treatment of initial acute patellar dislocation, we reviewed the charts of 399 patients with the diagnosis of an acute dislocation, seen during a 30 year period. One hundred patients (103 knees) met the criteria for inclusion in the study. The average age of the patient at injury was 21.7 years (range, 9 to 72 years). Length of followup averaged 8 years (range, 2 to 26 years). Retrospectively, we divided the patients into two groups, according to the examination of their unaffected knee. Group I (69 knees) showed evidence on examination of congenital abnormality of the extensor mechanism in the unaffected knee, indicating a predisposition to dislocate with less significant trauma. Group II (34 knees) showed no clinically perceptible congenital predisposition to dislocate based on examination of the unaffected knee. In the nonoperatively treated knees in Group I, there was a 52% (28/54) incidence of good or excellent results. The nonoperatively treated knees in Group II had a 75% (15/20) incidence of good or excellent results. Acute dislocation occurred more frequently in males than in females. Recurrence was rarer in patients whose initial dislocation had occurred when they were over 15 years old. Contrary to recently published reports, primary acute traumatic patellar dislocations can be treated with nonoperative therapy with good or excellent results. Initial evaluation should include examination of the uninvolved knee which, if found to have signs of congenital abnormality, would indicate a worse prognosis.

Author-supplied keywords

  • adolescent
  • adult
  • anti inflammatory agents
  • anti inflammatory agents therapeutic use
  • antineoplastic combined chemotherapy protocols
  • antineoplastic combined chemotherapy protocols th
  • asparaginase
  • asparaginase therapeutic use
  • central nervous system neoplasms
  • central nervous system neoplasms therapy
  • child
  • combined modality therapy
  • dexamethasone
  • dexamethasone therapeutic use
  • gene expression profiling
  • humans
  • methotrexate
  • methotrexate therapeutic use
  • precursor cell lymphoblastic leukemia lymphoma
  • precursor cell lymphoblastic leukemia lymphoma ge
  • precursor cell lymphoblastic leukemia lymphoma mo
  • precursor cell lymphoblastic leukemia lymphoma ra
  • precursor cell lymphoblastic leukemia lymphoma th
  • prognosis
  • remission induction
  • remission induction methods
  • risk assessment
  • stem cell transplantation
  • survival analysis

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Authors

  • M M Bern

  • L P Cloud

  • J C Corkery

  • J J Lokich

  • S Paul

  • D Phillips

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